| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,037 |
5,352 |
$480K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,946 |
2,658 |
$180K |
| 87428 |
|
230 |
203 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
248 |
244 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
1,200 |
1,119 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
164 |
155 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
31 |
$3K |
| 92587 |
|
110 |
109 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
79 |
75 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
24 |
23 |
$1K |
| 90686 |
|
90 |
90 |
$783.16 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
75 |
74 |
$617.33 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
33 |
$506.04 |
| 99173 |
|
131 |
131 |
$317.44 |
| 90688 |
|
15 |
15 |
$249.76 |
| 81003 |
|
28 |
27 |
$52.40 |
| 96160 |
|
203 |
200 |
$2.26 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
12 |
12 |
$0.00 |